Proposed algorithm for the post-operative monitoring of patients with CD. Evaluation strategies are determined by a patient’s immediate post-surgical status as determined by early morning serum cortisol levels. Asterisk repeat surgery practice varies by center. Longer follow-up could be considered in patients with subnormal levels of post-operative cortisol as they may either experience delayed remission and/or may not necessarily experience recurrence. Re-intervention can be considered if cortisol levels begin to rise or if symptoms of the disease return. Dagger UFC upper limit of normal (ULN) as determined by specific assay used. Double dagger medical therapy: pasireotide (somatostatin analog), cabergoline (dopamine receptor agonists), mifepristone (glucocorticoid receptor antagonist), steroidogenesis inhibitors (ketoconazole, mitotane, etomidate, metyrapone)